Dr. Philip Blanco Antiporta, M.D.
Internal Medicine, Infectious Disease in Fort Worth, TX. Individual provider (NPI-1).
NPI number1104139732
StatusActive
Last updated in NPPESMar 10, 2022
Details
- NPI
- 1104139732
- Entity type
- Individual (NPI-1)
- Name
- Dr. Philip Blanco Antiporta
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 25, 2010
- Certification date
- Mar 10, 2022
- Last updated
- Mar 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RI0200X | Internal Medicine, Infectious Disease | R8147 | TX | Yes |
| 207RI0200X | Internal Medicine, Infectious Disease | 036.133199 | IL |
Practice location
1325 Pennsylvania Ave Ste 350Fort Worth, TX 76104-2172
Phone 817-887-9389 · Fax 817-887-9392
Mailing address
Po Box 802772Dallas, TX 75380-2772
Phone 972-484-7700 · Fax 972-484-7718
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